Pain Management Health Center

What's Causing My Chest Pain?

Chest pain. The first thing you may think of is heart attack. Certainly chest pain is not something to ignore. But you should know that it has many possible causes. In fact, as much as a quarter of the U.S. population experiences chest pain that is not related to the heart. Chest pain may also be caused by problems in your lungs, esophagus, muscles, ribs, or nerves, for example. Some of these conditions are serious and life threatening. Others are not. If you have unexplained chest pain, the only way to confirm its cause is to have a doctor evaluate you.

You may feel chest pain anywhere from your neck to your upper abdomen. Depending on its cause, chest pain may be:

• Sharp
• Dull
• Burning
• Aching
• Stabbing
• A tight, squeezing, or crushing sensation 

Here are some of the more common causes of chest pain.

Chest Pain Causes: Heart Problems

Although not the only cause of chest pain, these heart problems are common causes:

Angina. A blockage in the heart blood vessels that reduces blood flow and oxygen to the heart muscle itself, causing pain but not permanent damage to the heart. The chest pain may spread to your arm, shoulder, jaw, or back. It may feel like a pressure or squeezing sensation. Chest pain from angina can be triggered by exercise, excitement, or emotional distress and is relieved by rest. 

Myocardial infarction (heart attack). This reduction in blood flow through heart blood vessels causes the death of heart muscle cells. Though similar to angina chest pain, a heart attack is usually a more severe, crushing pain and is not relieved by rest. Sweating, nausea, or severe weakness may accompany the pain.

Myocarditis. In addition to chest pain, this heart muscle inflammation may cause fever, fatigue, and trouble breathing. Although no blockage exists, myocarditis symptoms can resemble those of a heart attack.

Pericarditis. This is an inflammation or infection of the sac around the heart. It can cause pain similar to that caused by angina. However, it often causes a sharp, steady pain along the upper neck and shoulder muscle. Sometimes it gets worse when you breathe, swallow food, or lie on your back.

Hypertrophic cardiomyopathy. Heart failure occurs when the heart muscle becomes thickened. This makes the heart work harder to pump blood. Along with chest pain, this type of cardiomyopathy may cause dizziness, lightheadedness, shortness of breath, and other symptoms.

Mitral valve prolapse. Mitral valve prolapse is a condition in which a valve in the heart fails to close properly. A variety of symptoms have been associated with mitral valve prolapse, including chest pain, palpitations, and dizziness, although it can also have no symptoms, especially if the prolapse is mild.

Coronary artery dissection. A variety of factors can cause this rare condition, which results when a tear develops in the coronary artery. It may cause a sudden severe pain with a tearing or ripping sensation that goes up into the neck, back, or abdomen.